Despite HIV/AIDS risks, female condoms rare in Ugandan district

By

RONNIE LAYOO

Healthcare workers say more needs to be done to educate Ugandan women about female condoms and to make them readily available throughout the country. A worker distributed female condoms at a United Nations Population Fund booth in Nebbi in conjunction with International Women's Day festivities in 2012. UNFPA Uganda photo

When Lillian Acen, a village health team member in Uganda's Gulu District, went to distribute female condoms, she was shocked that women turned the condom rings into arm bracelets.

The fight against AIDS has been waged for more than three decades, with more people becoming infected each day, yet preventive measures such as female condoms are not being embraced in some areas of Gulu, a post-conflict region in northern Uganda, said the district's planner, John Luwa.

Luwa monitors statistics for the regional government, which says officially that 8 percent of the district's population is infected. He said Gulu has some of the highest HIV/AIDS rates in the country but accessibility to female condoms is still difficult for women.

Rural resident Anena Kevin, 25, says she looked for female condoms but has never seen them in nearby shops.

"No one has ever educated me on how to use a female condom," she said.

‘‘Both female and male condoms are like foreign bodies which don't make the act of having sex pleasant.”

Jenifer Akullu, an urban resident, said she has had experience with female condoms, but her husband advised her to stop using them because it lowered his sexual satisfaction.

Akullu said that in most government-run health centers, it is difficult to find the condoms.

The resident district commissioner of neighboring Lamwo District addressed the topic during a speech at the Uganda AIDS Commission regional meeting in Gulu earlier this year. The commission was established on a national level to work to stop the spread of sexually transmitted human immunodeficiency virus, which causes AIDS. Mole Ayoo said that unlike male condoms, female condoms are nowhere to be found.

She said she had gone years without seeing a female condom, “yet the government says they are fighting HIV/AIDS without protecting women.” ‘‘We need assurance that female condoms are not harmful," Ayoo said, noting in the past they had burst during use.

Both the World Health Organization and the Ugandan Ministry of Health say the condoms are an effective form of birth control and protection against sexually transmitted diseases. WHO is developing international standards to make them more consistent.

The head nurse at the AIDS clinic in Gulu Regional Referral Hospital, Jenifer Amono, said that although female condoms have been around for more than a decade, they are not common, making it difficult for women to obtain them.

Amono said efforts by national Health Ministry and hospital officials to increase awareness have been low. She said even the few condoms delivered to the hospital are not requested, but are left to expire.

‘‘Many women are unaware about the female condoms' availability and prefer male condoms,'' she stated.

Although there has been a slight drop in the percentage of people in the district who are infected with HIV/AIDS, from 10.5 percent to 8 percent, the district health officer, Dr. Paul Onek, attributes it to other causes -- for example, safe male circumcision, and nighttime HIV/AIDS testing, which targets those with risky behaviors such as prostitutes and long-distance drivers.

Healso said there is a need to distribute female condoms.

Onek said female condoms are delivered to the district's 54 health centers and three regional hospitals, but very few of the district’s more than 8,000 women turn up to obtain them.

Onek said the condoms are very costly, and affordability is an issue for women.

Dr. Shaban Mugeruwa, a spokesman from the national Ministry of Health, said the ministry is aware of women's limited knowledge of female condoms. He suggested that anatomical models should be introduced to demonstrate how female condoms are used.

Mugeruwa said the ministry only procured a year’s supply of 2.4 million female condoms for all the health centers and regional referral hospitals for the country and its 8.5 million sexually active women.

He noted that when using female condoms a male condom is not required and female condoms have been improved with increased lubrication that boosts sensitivity.

Mugeruwa said there is a need for more education campaigns and sensitization on the use of female condoms, as well as the installation of condom-dispensing machines in strategic places such as hotels and bars.